Endoscopy 2022; 54(02): 158-162
DOI: 10.1055/a-1364-4160
Innovations and brief communications

A novel endoscopic purse-string suture technique, “loop 9”, for gastrointestinal defect closure: a pilot study

Haruhiro Inoue
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Mayo Tanabe
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
2   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain
,
Yusuke Fujiyoshi
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Akiko Toshimori
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Yohei Nishikawa
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Kosuke Nashida
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Kazuya Sumi
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Haruo Ikeda
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Manabu Onimaru
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Naoyuki Uragami
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
› Author Affiliations
Trial Registration: UMIN Japan (http://www.umin.ac.jp/english/) Registration number (trial ID): UMIN000040467 Type of study: Prospective
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Abstract

Background This study aimed to assess the feasibility and efficacy of the novel loop 9 method of gastrointestinal (GI) defect closure.

Methods 20 patients underwent a GI procedure that required defect closure. Loop 9 can be delivered through a single instrument channel (3.2 mm) and released at the defect site. After it has been anchored by two clips positioned on opposite sides of the defect edge, the loop 9 is tightened by pulling the end of the suture intraluminally using biopsy forceps. Additional clips are placed to achieve complete closure. The primary outcome was complete closure rate. The secondary outcomes were closure time, sustained closure rate, and adverse events.

Results Complete closure was achieved in 100 % of cases. The mean size of the mucosal defects was 17.5 mm (range 10–55 mm). The median closure time was 14 minutes. The sustained closure rate was 90 %. No adverse events were noted.

Conclusions The loop 9 technique is feasible and effective in achieving complete and sustained closure of therapeutic endoscopy-related GI defects.

Tables 1s, 2s, Fig. 1s



Publication History

Received: 04 December 2020

Accepted: 19 January 2021

Accepted Manuscript online:
20 January 2021

Article published online:
16 March 2021

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